| NPI | 1114052164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLYSON MERTINS Owner 479-442-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AR 2462) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR 2462) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2024-03-18 |